From Relief to Self-Reliance

Emergency SRH interventions in drought affected and food-insecure areas, Ethiopia

IAWG annual meeting, Kuala Lumpur, May 31-June 01, 2013 Tenaw Bawoke – IMC Ethiopia

©2012 International Medical Corps

Presentation outline

• • • • • • • Background Introduction Program Objective Program approaches Program findings/outcomes Limitations Next steps ©2012 International Medical Corps 2

1. Background

• Main RMNCH indicators of Ethiopia (2011 DHS) –

MMR (per 100,000 live births) - 676

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ANC (4+) – 19 %

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ANC (1+) – 43 %

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TFR – 4.4

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Institutional delivery (per 1,000 live births) – 10

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CPR – 29 %

– U5MR (per 1,000 live births) – 88 – IMR (per 1,000 live births) - 59 –

NMR (per 1,000 live births) – 37

©2012 International Medical Corps 3

•

1. Background ….

Backgrounds of E & S Ethiopia – Pastoralist & semi-pastoralist zones which are frequently affected by: • Malnutrition and food insecurity. • In times of emergency, women and adolescent girls are exposed to: – Anemia, unsafe abortion, GBV/rape, HIV/STI infection, un-planned pregnancy and delivery complications. . ©2012 International Medical Corps 4

2. Introduction

IMC MISP intervention portfolio in Ethiopia (rapid and slow onset emergencies) – integrated with WASH & Nutrition intervens.



Slow onset emergencies

 Drought-affected pops of Somali Region, Sep 2006 – Apr 2007 

AWD affected comms of E & W Harrarge

, May-Oct 2008  Drought-affected pops of Wolayita , Apr-Sept 2009 

Drought-affected pops of Wolayita

, Apr-Dec 2010 

Drought-affected comms of E/H & Wolayita

, Sept 2011 – Apr 12 

Drought –affected comms of Wolayita

, 2013 

Rapid onset emergencies



Somali refugees in Dollo Ado refugee corridor

, Aug–Oct 2010  GBV program in Dollo Ado refugee corridor, Aug 2010 - Now ©2012 International Medical Corps 5

IMC RH intervention areas – blue highlighted

©2012 International Medical Corps 6

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3. Program Objective

Contribute to reduce excess maternal and adolescent girls mortality and morbidity in drought-affected areas and refuge settings, through emergency RH, HIV and GBV responses.

©2012 International Medical Corps 7

4. Program approaches/strategies Facility based supply side Commu. Based demand side

- Improve access to quality SRH services - Enhance capacity of Health Extension Workers (HEWs), health professionals and health managers - Enhance capacity of community volunteers/Health Development Armies (HDAs)/CC facilitators - Enhance utilization of SRH information and services

Reduce effect of the crisis on SRH

©2012 International Medical Corps 8

5. Program out puts/outcomes

• Major outputs and outcomes achieved during 2012 & 2013: – Needs assessments conducted in 48 health facilities – 100% of health facilities supplied with SRH medicines, supplies and equipment including RH kits as per the gaps assessed – > 20 HFs got power using solar technology – 13 HFs got permanent water source – 100% of HFs supplied with Iron and Folic Acid (IFA) supplements – Adolescent friendly services provided in health facilities ©2012 International Medical Corps 9

• • • • •

5. Program out puts….

50% health workers, HEWs and HDAs received training on – BEmONC – Gender and HIV/AIDS in emergency context – Clinical management of rape survivors and referrals – STI case management and – ASRH in crisis settings Target communities received RH information including HIV/AIDS and GBV through edutainment, CC and IEC materials 11, 283 pregnant women provided with Clean delivery kits (CDKs) 4,000 women and girls supplied with menstrual hygiene supplies/dignity kits Organized youth got Audio-visual materials ©2012 International Medical Corps 10

• • • • • •

5. Program out puts….

20 stretchers provided to community volunteers MISP interventions integrated with emergency nutrition and WASH interventions. The programs strengthened primary health care services to implement MISP and improved community health seeking behavior during emergencies MISP institutionalized with existing primary health care services Stakeholders accepted SRH issues as part of humanitarian responses Reduced effects of drought on the SRH condition ©2012 International Medical Corps 11

• HEWs providing health education to pregnant mothers ©2012 International Medical Corps 12

• SRH FGD/CC conducted with female Adolescents 13

CC in rural area

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• ANC provided to pregnant mother by trained HW 15

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6. Limitations

• • • RH undermined during emergencies Trained staff attrition Sustainability – youth SRH programs ©2012 International Medical Corps 18

8. Next steps

• • Ensuring sustainability Integrating MISP with primary health care and community based comprehensive SRH programs ©2012 International Medical Corps 19

Thank You

©2012 International Medical Corps 20